Improving Health Care Quality: Can Federal Efforts Lead the Way?

The quality of health care in the United States is on the national policy agenda. Research suggests that quality of care varies across different population groups, regions, and institutions and among clinicians. The significant changes that occurred in the U.S. health care delivery system since the advent of managed care focused the attention of purchasers, payers, providers, and consumers on the state of health care quality, the reasons why quality deficiencies arise, and ways to improve quality. The federal government has assumed a central role in developing better ways to measure quality, gathering evidence regarding quality problems, and implementing strategies to address them.